Diagnostic and Therapeutic Value of Endoscopic Retrograde Cholangiopancreatography in Acute Cholangitis: A Study From Kashmir Valley, India.

Background Cholangitis, or bile duct infection, can present in two primary forms, namely, acute ascending cholangitis (the milder form) and acute fulminant cholangitis (the more severe variety). In all types of cholangitis, bile duct obstruction occurs, with choledocholithiasis (the presence of gallstones in the bile duct) being the leading cause of this blockage. is the most commonly isolated pathogen in these infections.

Determine Complete Blood Count Reference Values Among Healthy Adult Populations.

Background: Complete blood counts (CBC) are commonly used in diagnostic medicine to evaluate normal and abnormal hematological status. Furthermore, reference values (RVs) of CBC supplied by researchers are the most reliable means of the judgment-making stage and can aid interpretation and accurate diagnosis of diseases. Reference values vary between peoples because of differences in lifestyle, dietary habits, ethnicity and environment.

Elsberg syndrome - A systematic review of existing scientific literature from 2000 - 2023.

Objective: To assess the clinical presentation, causative agents, and treatment outcomes in patients diagnosed with Elsberg syndrome (ES).

Methods: A thorough literature search was conducted on the mentioned topic using PRISMA guidelines via PubMed, Google Scholar, and SCOPUS. Articles published between 2000 and 2023 were included using advanced search and Boolean strategy.

K-line guided approach selection and outcomes assessment for Cervical Ossification of Posterior Longitudinal Ligament (OPLL): A case series with literature review from Pakistan.

Objectives: To analyze the efficacy of K-line in surgical planning of approach selection for ossification of posterior longitudinal ligament (OPLL) and outcomes assessment by Nurick grading and Modified Japanese Orthopaedic Association (mJOA) scores.

Methods: This is a retrospective case series study conducted at the Departments of Neurosurgery, Punjab Institute of Neurosciences, Lahore in the months of January and February 2024. Patients with complete records were considered.

Effect of Bilateral Subthalamic Nucleus (STN) Deep Brain Stimulation (DBS) on drug reduction for Parkinson's Disease: A retrospective observational study from Pakistan.

Objectives: To determine the effect of Bilateral Subthalamic Nucleus (STN) Deep Brain Stimulation (DBS) on drug reduction for Parkinson's disease (PD) in a low-middle-income country.

Methods: This retrospective cohort study included 49 patients following interview based questionnaires who underwent bilateral STN DBS at the Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore, Pakistan over five years (July 30, 2018 to June 29, 2023). Patients meeting the inclusion and exclusion criteria (49 patients) were selected and the effect of bilateral STN DBS on drug reduction was evaluated.

Post-traumatic extensive chronic osteomyelitis of skull vault: An illustrative case report.

Chronic osteomyelitis of the skull base is a commonly reported pathology in existing scientific literature, but chronic osteomyelitis of the skull vault (COSV) is a rarely documented disease. We report the case of a 38 years old Afghan male with a presenting complaint of irregular swelling on the skull vault for six months. The patient had a history of head trauma one year back with a compound depressed fracture which had been surgically managed then.

Takotsubo Cardiomyopathy in Epilepsy: A Systematic insight into the Existing Literature from 2000-2023.

Background & Objective: Takotsubo cardiomyopathy (TCM), manifests as left ventricular dysfunction triggered by physical or emotional stress. It leads to higher morbidity in epileptic patients and can progress to complications. To find out the correlation between Takotsubo cardiomyopathy and epilepsy and to investigate pathophysiology and associated types of epilepsy.

Free-hand Frameless Pinless Electromagnetic-Navigation (AXIEM™)-Guided Brain Lesion Biopsies: An Institution Based Experience from a Low-Middle-Income Country.

Objectives: To evaluate the precision and safety of a novel technique of free-hand frameless pinless AXIEM™-based navigation guided biopsy of deep-seated brain lesions in a low-middle income country.

Methods: This retrospective study included 45 patients who underwent free-hand frameless pinless AXIEM™-based navigation guided biopsy of deep-seated brain lesions using the Medtronic-Stealth S7 system over a 5-year period (January 2019 to December 2023) at the Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore, Pakistan.

Results: A total of 45 patients were included in this study.

Radiometric and Morphologic Analysis of Arnold Chiari Type-I Malformation and Idiopathic Syringomyelia: A Case Series from Pakistan.

Background And Objective: Chiari I Malformation-associated syringomyelia (CM) and idiopathic syringomyelia (IS) are often confused together. They require different diagnostic approach and treatment modalities; it is important to distinguish between the two. We aimed to evaluate the radiological and morphologic characteristics of CM and IS in adult and pediatric patients in Pakistani population.

Incidence of postoperative cerebrospinal fluid leaks in endoscopic endonasal transsphenoidal surgery for pituitary adenomas without sellar floor reconstruction: A retrospective observational study from a low-middle-income country.

Objectives: To determine the incidence of postoperative cerebrospinal fluid (CSF) leaks after endoscopic endonasal transsphenoidal surgery (EETS) for pituitary adenomas without sellar floor reconstruction (SFR).

Methods: This retrospective observational study was conducted at Department of Neurosurgery, Punjab Institute of Neurosciences (PINS), Lahore, Pakistan from January, 2018 to December, 2022. It is a non-probability based consecutive case series.

Knowledge, Attitude and Perception of Research Ethics and Research Ethics Committees among Post-Graduate Residents of Neurosciences - A Nationwide Analysis from Pakistan.

Objectives: To assess the knowledge, attitude and perception of post-graduate residents of neurosciences towards research ethics (RE) and research ethics committees (RECs).

Methods: This prospective cross-sectional survey-based study was conducted by the Punjab Institute of Neurosciences, targeting post-graduate neuroscience residents throughout Pakistan during January and February, 2024. An English-language general questionnaire, designed to assess knowledge, attitudes, and perceptions of RE and RECs, was adapted to reflect local conditions.

Complexity of arachnoid adhesions dictating the outcome of microvascular decompression for trigeminal neuralgia.

Objective: Multiple techniques have been used to treat trigeminal neuralgia (TGN), including pharmacotherapy, radiosurgery, rhizotomy and microvascular decompression (MVD). Blood vessels are considered to be the most common cause of offense and compression to trigeminal nerve. We aimed to determine the causes of classic TGN and efficacy of MVD.

Multiple primary brain abscesses in a 14 years old immunocompetent boy: A tale of Proteus mirabilis infestation from Pakistan.

Brain abscess (BA) formation that may be due to due to Gram-positive bacteria commonly and less commonly due Gram-negative bacteria affects pediatric population. Most cases are secondary to the involvement of ear, nose, throat and sinuses (ENTS). We describe a rare case of a 14 year old patient presenting with generalized tonic clonic seizures for the last six months associated with fever, vomiting and headache.

Primary Aneurysmal Bone Cyst of Sacrum: A Case Report of a 12 years old boy from Pakistan.

Aneurysmal bone cysts are locally invasive, benign lesions usually found in the spine or metaphysis of long bones. They can be primary (idiopathic) or secondary to other bone pathologies. Primary aneurysmal bone cyst usually occurs in the first two decades of life.

Surgical outcomes of delayed clipping in ruptured intracranial aneurysms of anterior circulation: Experience from a low-middle-income country.

Objective: To evaluate the surgical outcomes of delayed microsurgical clipping for ruptured intracranial aneurysms (RICAs) of anterior circulation.

Methods: This retrospective, cross-sectional study assessed the surgical outcomes of 50 patients who underwent surgical clipping for "ruptured aneurysms" with subarachnoid haemorrhage after the 21 post-bleed day, from May 01, 2022, till May 01, 2023, at the Department of Neurosurgery, Punjab Institute of Neurosciences, Lahore, Pakistan.

Results: The mean age of patients was 49.

Cerebellopontine angle paraganglioma masquerading as vestibular schwannoma.

Paragangliomas are slow-growing, extra-adrenal neuroendocrine tumors with rare intracranial presentation. Although benign, they can be locally aggressive tumors causing bone destruction and compression related symptoms. We report the case of a 19 years old, normotensive female who presented with headache and vertigo for the past six months.

Identification of dimethyl 2,2'-((methylenebis(2-(2H-benzo[d][1,2,3]triazol-2-yl)-4-(2,4,4-trimethylpentan-2-yl)-6,1phenylene))bis(oxy))diacetate (TAJ4) as antagonist of NEK-Family: a future for potential drug discovery.

The purpose of the current study was to analyze and validate the existing gap in knowledge, by conducting a differential expression analysis and validation of NEK6, NEK7, and NEK9 in breast, cervical, and glioblastoma cancer and targeting these proteins through development of novel site specific inhibitor with favorable pharmacokinetic and safety profile, using open-source databases. The analysis revealed that the targeted kinases were overexpressed in all three types of cancer. Their expression was significantly linked to overall survival rates, which suggests that they play a major role in the development and progression of these cancers.

Hyperphenylalaninemia and serotonin deficiency in Dnajc12-deficient mice.

Serotonin exerts numerous neurological and physiological actions in the brain and in the periphery. It is generated by two different tryptophan hydroxylase enzymes, TPH1 and TPH2, in the periphery and in the brain, respectively, which are members of the aromatic amino acid hydroxylase (AAAH) family together with phenylalanine hydroxylase (PAH), degrading phenylalanine, and tyrosine hydroxylase (TH), generating dopamine. In this study, we show that the co-chaperone DNAJC12 is downregulated in serotonergic neurons in the brain of mice lacking TPH2 and thereby central serotonin.

Coinfection and Clinical Impact of Enterotoxigenic Escherichia coli Harboring Diverse Toxin Variants and Colonization Factors: 2017-2022.

Objectives: The severity of the diarrhea disease is exacerbated by co-infections that involve Enterotoxigenic Escherichia coli (ETEC) and other enteric pathogens, which complicate the diagnosis and treatment. This study explores the prevalence, clinical manifestations, and risk factors of ETEC and its co-infections in Dhaka, Bangladesh.

Methods: The study used data from the Diarrheal Disease Surveillance System at Dhaka Hospital, involving 16,276 patients from 2017-2022.

Optimal Combination of Different Selection and Mating Strategies on Exploiting Genetic Diversity and Genetic Gain in Small Pig Conservation Populations.

Both selection and mating systems are essential tools for breeders to conserve the genetic variance and improve the performance of livestock animals. How to effectively balance the genetic gain and inbreeding has always been an important issue in quantitative genetics research. In this study, a total of 11 selection methods, including random and truncation selection, six conventional selection methods, three different optimal contribution selection (OCS) methods and three mating strategies including random mating, minimum-coancestry mating based on pedigree (MCPed) and genomic information (MCmarker), were performed using stochastic simulations.

Cytokine Storm among Bangladeshi adults with COVID-19: A prospective cohort study.

Objective: In COVID-19, cytokine storms (CS) result in higher mortality and morbidity. Our study evaluated the rate of cytokine storms among COVID-positive Bangladeshi adults.

Methods: From October 2020 to March 2022, this cohort study enrolled both COVID-positive and COVID-negative healthy adults.

Data-driven cluster analysis identifies distinct types of metabolic dysfunction-associated steatotic liver disease.

Metabolic dysfunction-associated steatotic liver disease (MASLD) exhibits considerable variability in clinical outcomes. Identifying specific phenotypic profiles within MASLD is essential for developing targeted therapeutic strategies. Here we investigated the heterogeneity of MASLD using partitioning around medoids clustering based on six simple clinical variables in a cohort of 1,389 individuals living with obesity.

How to Manage a Large Undifferentiated Lung Cancer Mass: A Case Report.

Non-small cell lung cancer is the most common type of lung cancer globally. An important subtype to discuss is undifferentiated carcinomas, which are variants of large cell carcinoma, and these can typically present with evidence of neuroendocrine differentiation. The patient presented with a large mass in the right upper lobe extending into the middle lobe.